Key result
Impaired left ventricular diastolic performance, specifically peak filling rate, was the prime independent predictor of late cardiac deaths 10 to 17 years after valve replacement for aortic stenosis.
Why the study?
Does impaired left ventricular diastolic performance predict late cardiac deaths in patients who underwent isolated valve replacement for aortic stenosis?
Cohort (n=63)
Does impaired left ventricular diastolic performance predict late cardiac deaths in patients who underwent isolated valve replacement for aortic stenosis?
Impaired left ventricular diastolic performance, specifically peak filling rate, is a strong independent predictor of late cardiac death 10-17 years after valve replacement for aortic stenosis.
Impaired diastolic performance may warrant closer long-term surveillance after aortic stenosis valve replacement; leaves open prospective validation of its role in guiding therapy.
Sixty-three patients took part in a follow-up study ten to seventeen years after valve replacement for aortic stenosis. Data obtained were used to predict cardiac deaths (n = 14) occurring in the following three-year period. The degree of residual left ventricular (LV) hypertrophy correlated inversely with indices for LV systolic and diastolic performance (radionuclide cardiography). A logistic regression (LR) model had a positive predictive value for cardiac deaths of 100% (10/10) with 8% (4/53) false negatives. Evaluating LV performance indices exclusively, LR analysis showed that only peak filling rate had independent predictive value. Subnormal and normal LV ejection fractions were associated with equal three-year cardiac death rates (29%). Depressed LV function was related to residual hypertrophy. Impaired diastolic performance was the prime predictor of cardiac deaths.
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Lund et al. (1989) conducted a cohort in Aortic Stenosis (n=63). Left ventricular performance indices (peak filling rate) was evaluated on Cardiac deaths. Impaired left ventricular diastolic performance, specifically peak filling rate, was the prime independent predictor of late cardiac deaths 10 to 17 years after valve replacement for aortic stenosis.
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